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The SES Health Gradient on Both Sides of the Atlantic

In: Developments in the Economics of Aging

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  • James Banks
  • Michael Marmot
  • Zoe Oldfield
  • James P. Smith

Abstract

In this paper we investigate the size of health differences that exist among men in England and the United States and how those differences vary by Socio-Economic Status (SES) in both countries. Three SES measures are emphasized - education, household income, and household wealth - and the health outcomes investigated span multiple dimensions as well. International comparisons have played a central part of the recent debate involving the 'SES health gradient' with some authors citing cross-country differences in levels of income equality and mortality as among the most compelling evidence that unequal societies have negative impacts on individual health outcomes. In spite of the analytical advantages of making such international comparisons, until recently good micro data measuring both SES and health in comparable ways have not been available for both countries. Fortunately, that problem has been remedied with the fielding of two surveys - the Health and Retirement Survey (HRS) and the English Longitudinal Survey of Aging (ELSA). In order to facilitate the type of research represented in this paper, both the health and SES measures in ELSA and HRS were purposely constructed to be as directly comparable as possible. Our analysis presents data on some of the most salient issues regarding the social health gradient in health and the manner in which this health gradient differs for men across the two countries in question. There are a several key findings. First, looking across a wide variety of diagnosed diseases, average health status among mature men is much worse in America compared to England, confirming non-gender specific findings we reported in earlier research. Second, there exists a steep negative health gradient for men in both countries where men at the bottom of the economic hierarchy are in much worse health than those at the top. This social health gradient exists whether education, income, or financial wealth is used as the marker of SES. While the neg

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This chapter was published in:

  • David A. Wise, 2009. "Developments in the Economics of Aging," NBER Books, National Bureau of Economic Research, Inc, number wise09-1, October.
    This item is provided by National Bureau of Economic Research, Inc in its series NBER Chapters with number 11324.

    Handle: RePEc:nbr:nberch:11324

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    References

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    Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
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    1. James Banks & Richard Blundell & James P. Smith, 2003. "Understanding Differences in Household Financial Wealth between the United States and Great Britain," Journal of Human Resources, University of Wisconsin Press, vol. 38(2).
    2. James P. Smith, 2004. "Unravelling the SES health connection," IFS Working Papers W04/02, Institute for Fiscal Studies.
    3. Arie Kapteyn & James P. Smith & Arthur van Soest, 2004. "Self-reported Work Disability in the US and The Netherlands," Working Papers 206, RAND Corporation Publications Department.
    4. Adams, Peter & Hurd, Michael D. & McFadden, Daniel & Merrill, Angela & Ribeiro, Tiago, 2003. "Healthy, wealthy, and wise? Tests for direct causal paths between health and socioeconomic status," Journal of Econometrics, Elsevier, vol. 112(1), pages 3-56, January.
    5. Michael Hurd & F. Thomas Juster & James P. Smith, 2003. "Enhancing the Quality of Data on Income: Recent Innovations from the HRS," Journal of Human Resources, University of Wisconsin Press, vol. 38(3).
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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Science, ego and power
      by chris dillow in Stumbling and Mumbling on 2011-11-02 13:49:36
    2. Recessions kill
      by chris dillow in Stumbling and Mumbling on 2008-08-13 13:43:11
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    Cited by:
    1. David M. Cutler & Adriana Lleras-Muney & Tom Vogl, 2008. "Socioeconomic Status and Health: Dimensions and Mechanisms," NBER Working Papers 14333, National Bureau of Economic Research, Inc.
    2. Oswald, Andrew J. & Powdthavee, Nattavudh, 2007. "Obesity, Unhappiness, and The Challenge of Affluence: Theory and Evidence," IZA Discussion Papers 2717, Institute for the Study of Labor (IZA).
    3. David G. Blanchflower & Andrew J. Oswald & Bert Van Landeghem, 2009. "Imitative Obesity and Relative Utility," Journal of the European Economic Association, MIT Press, vol. 7(2-3), pages 528-538, 04-05.
    4. Kajal Lahiri & Zulkarnain Pulungan, 2006. "Health Inequality and Its Determinants in New York," Discussion Papers 06-03, University at Albany, SUNY, Department of Economics.
    5. Datta Gupta, Nabanita & Kleinjans, Kristin J. & Larsen, Mona, 2011. "The Effect of an Acute Health Shock on Work Behavior: Evidence from Different Health Care Regimes," IZA Discussion Papers 5843, Institute for the Study of Labor (IZA).
    6. Michael Lokshin & Martin Ravallion, 2008. "Testing for an economic gradient in health status using subjective data," Health Economics, John Wiley & Sons, Ltd., vol. 17(11), pages 1237-1259.
    7. Emma Tominey, 2007. "Maternal Smoking During Pregnancy and Early Child Outcomes," CEP Discussion Papers dp0828, Centre for Economic Performance, LSE.
    8. Ciro Avitabile & Tullio Jappelli & Mario Padula, 2008. "Screening Tests, Information, and the Health-Education Gradient," CSEF Working Papers 187, Centre for Studies in Economics and Finance (CSEF), University of Naples, Italy, revised 28 Apr 2008.
    9. Majo, Maria Cristina & van Soest, Arthur, 2012. "Income and health care utilization among the 50+ in Europe and the US," Applied Econometrics, Publishing House "SINERGIA PRESS", vol. 28(4), pages 3-22.
    10. Stefan Hupfeld, 2011. "Non-monotonicity in the longevity–income relationship," Journal of Population Economics, Springer, vol. 24(1), pages 191-211, January.
    11. Lahiri, Kajal & Pulungan, Zulkarnain, 2007. "Income-related health disparity and its determinants in New York state: racial/ethnic and geographical comparisons," MPRA Paper 21694, University Library of Munich, Germany.

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